| NPI | 1043848393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: NY 316700) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: MA 3013491) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2025-06-02 |